Workers' Compensation (Script 285)

From Clicklaw Wikibooks

The Dial-A-Law library is prepared by lawyers and gives practical information on many areas of law in British Columbia. This script gives information only, not legal advice. If you have a legal problem or need legal advice, you should speak to a lawyer. For the name of a lawyer to consult, call the Lawyer Referral Service at 604.687.3221 in the lower mainland or 1.800.663.1919 elsewhere in British Columbia.

What is Workers’ Compensation?

Workers’ Compensation is a government program under the Workers Compensation Act. It is run by the Workers’ Compensation Board of BC and paid for by employers. The Workers’ Compensation Board uses the name WorkSafeBC. The program is designed to:

pay workers for some of their lost income and certain expenses if they suffer a workplace injury or disease—regardless of who was at fault – or to pay a worker’s family if the worker dies from the injury or disease.

help injured workers get back to work.

promote health and safety in the workplace, and prevent and respond to workplace bullying and harassment (including sexual harassment).

Who can get Workers’ Compensation?

The program covers almost all workers, both full- and part-time, including office workers, farm workers, performers, and domestic workers. Unregistered labour contractors may also be entitled to benefits. Independent contractors can register with the program for personal optional protection. If they don’t do this, they are not entitled to compensation for work injuries or diseases.

If you suffer a workplace injury or disease, you may be able to get one or more of the following benefits. A workplace injury or disease can include a mental disorder. For example, a worker who is sexually harassed at work and suffers a mental disorder from it, may be able to get compensation (even if the harassment did not involve a physical injury). Script 271 explains sexual harassment.

Types of benefits

These benefits pay you, at least partly, for income you lose because of your workplace injury or disease. If you are injured and unable to work, the benefits are usually 90% of your net wages at the time of your injury or disease. These benefits pay you for lost income, but only up to a maximum wage (adjusted each year). If you remain temporarily disabled after 10 weeks, WorkSafeBC may recalculate your benefits based on your net income in the 12 months before your injury or disease. Wage loss benefits continue until you are no longer temporarily disabled or your condition becomes stable. “Stable” means your condition stays the same and the medical evidence indicates it will probably not get any better or worse over the next 12 months.

2. Long-term or permanent disability and retirement benefits, and death benefits

If you are permanently disabled, totally or partly, you may be able to get permanent disability benefits and retirement benefits. These are paid in one of two ways: a “permanent functional impairment (PFI) award” or a “loss of earnings (LOE) award.” Usually, WorkSafeBC pays a PFI award, to compensate you based on the kind of injury you have. But if WorkSafeBC finds that a PFI award does not properly compensate you—because your disability reduces your ability to continue working in your occupation to an exceptional extent—it may pay an LOE award. Although a permanent disability award covers permanent chronic pain, it does not cover loss of enjoyment of life, or damage to your clothes or vehicle.

WorkSafeBC won’t decide about any permanent disability until your condition becomes stable. That means your condition stays the same and the medical evidence indicates it will probably not get any better or worse over the next 12 months.

Normally, if long-term benefits are more than $200 a month, they are paid monthly. If benefits are less than $200 a month, you will probably get a lump-sum payout. Even if WorkSafeBC plans to pay you benefits monthly, you can apply for a commutation (a lump-sum payout) of all or part of your award. Generally, you won’t get a commutation if the benefits are more than $200 a month. You may get a commutation only if it improves your income. And you must have another stable income source, apart from the benefits.

Families of workers who are killed on the job or die from a workplace injury or disease, may qualify for an award and vocational training help.

3. Health care benefits

Health care benefits pay for doctors, hospitals, nursing care, home care, prescription drugs, and other health care professionals like physiotherapists, dentists, and chiropractors. They also cover other expenses, including medical supplies, appliances like crutches, hearing aids, dentures, and eyeglasses, and modifications to home, vehicles, and workplace.

4. Vocational rehabilitation benefits

If WorkSafeBC decides that you cannot return to your pre-injury job because of your injury and your employer cannot offer a modified job, you may be entitled to vocational rehabilitation services. These benefits are for vocational retraining, workplace redesign or job modification, training on the job, and job search activity. If your injury or disease eventually forces you to change your occupation, you should think about your future educational and vocational needs. You should ask WorkSafeBC for rehabilitation guidance to help you plan your future. You have to take charge of your own rehabilitation. If you have a good idea of what you want, you explain it, and it is appropriate, the more likely you are to get it.

How to apply for benefits

Report the injury or illness immediately—if you suffer a workplace injury or illness, report it immediately to your employer, your doctor and WorkSafeBC. You can get application forms from your employer, your union, or the WorkSafeBC website. Call 604.231.8888 in the lower mainland and 1.888.967.5377 elsewhere in BC (free of charge). Your employer and your doctor must report your injury or disease to WorkSafeBC within 3 days of when you tell them about it.

Apply to WorkSafeBC for benefits—you must apply to WorkSafeBC if you want benefits. Just reporting an injury to your employer and doctor is not enough.

Time limit to apply for benefits—you have only one year from your accident or disease to apply for compensation. After that, you may lose your right to benefits unless special circumstances stopped you from applying on time.

What happens when you apply—a WorkSafeBC officer will examine your claim and decide if you get benefits, and if so, the type and amount.

Deciding whether you get benefits can be complicated. You should discuss your case with your union, a lawyer, or the Workers’ Advisers Office. Workers’ Advisers work for the Ministry of Labour to help workers with their claims. They are separate from WorkSafeBC and there’s no charge for their service. Their phone numbers are 604.713.0360 in Vancouver and 1.800.663.4261 elsewhere in BC.

Reviews and Appeals—if you disagree with the WorkSafeBC decision

Reviews—if WorkSafeBC decides that you are not eligible for benefits, or if you don’t understand its decision, ask the WorkSafeBC officer handling your claim for an explanation. Ask for a decision letter if you didn’t already get one. If you’re still not satisfied, you can ask the Review Division of WorkSafeBC to review the decision.

In a few cases, you can only appeal to the Workers’ Compensation Appeal Tribunal (you can’t ask for a review). These cases are Board decisions to reopen (or not reopen) a matter, and decisions on discriminatory action complaints (that an employer punished you for raising safety concerns at work). Appeals are explained below.

Time limit to ask for review—you must ask for a review within 90 days of the date of WorkSafeBC’s decision letter or, in some cases, within 90 days of the date when WorkSafeBC told you its decision orally or stopped paying you. WorkSafeBC should automatically give you a copy of your claim file and you can use the information in it for your review. After you request a review, you will receive a letter setting a time to make written submissions. The Review Division does not normally hold oral hearings.

The Review Division considers the written submissions and WorkSafeBC’s file and gives its decision, usually within 150 days. The WorkSafeBC website has more information on reviews. The phone numbers for the Review Division are 604.214.5411 in the lower mainland and 1.888.922.8804 elsewhere in BC. At the same time, if you feel that WorkSafeBC has treated you unfairly, you can also complain to its Fair Practices Office and the Ombudsperson of BC at 1.800.567.3247).

Appeals—if you disagree with the decision of the Review Division, you can usually appeal to the Workers’ Compensation Appeal Tribunal. But you cannot appeal decisions of the Review Division on specific issues, such as vocational rehabilitation, commutations, prevention orders (other than penalties), and certain types of disability awards.

Time limit to appeal—if you decide to appeal, you must do so within 30 days of the decision of the Review Division. For cases that go directly to the Tribunal, the time limit is 90 days.